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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200155
Report Date: 02/03/2026
Date Signed: 02/03/2026 01:33:06 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/02/2025 and conducted by Evaluator Tonica Syess-Gibson
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20251102161233
FACILITY NAME:WOODFIELD CARE FACILITYFACILITY NUMBER:
079200155
ADMINISTRATOR:TONI PAPIAFACILITY TYPE:
735
ADDRESS:273 WOODFIELD LANETELEPHONE:
(925) 420-5637
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY:6CENSUS: 5DATE:
02/03/2026
UNANNOUNCEDTIME BEGAN:
12:11 PM
MET WITH:Christina McGriff, Direct Support StaffTIME COMPLETED:
01:53 PM
ALLEGATION(S):
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Staff are mismanaging residents' medications.
INVESTIGATION FINDINGS:
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On 02/03/2026 at 12:11PM, Licensing Program Analyst (LPA), T. Syess-Gibson arrived unannounced to deliver complaint findings for the allegation above. LPA met with Christina McGriff and explained the reason for the visit.

Allegation: Staff are mismanaging residents' medications.

During the investigation, Interviews with staff (S1, S2, S3) and C1 revealed staff allow C1 to administer C1's medication. Record review revealed C1 is not able to administer own prescribed medications, manage and store own medications.

Continue on LIC9099C...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Tonica Syess-Gibson
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 15-AS-20251102161233
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: WOODFIELD CARE FACILITY
FACILITY NUMBER: 079200155
VISIT DATE: 02/03/2026
NARRATIVE
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Continued from LIC9099




Based on LPA's information obtained during investigation, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, are being cited on the attached LIC9099D.

Exit interview conducted. A copy of this report and appeal rights provided to Christina McGriff.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Tonica Syess-Gibson
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 15-AS-20251102161233
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: WOODFIELD CARE FACILITY
FACILITY NUMBER: 079200155
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/03/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/04/2026
Section Cited
CCR
80075(b)
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80075(b) Clients shall be assisted as needed with self-administration of prescription and nonprescription medications. This requirement was not met as evidenced by:
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By POC due date, licensee agreed to submit to CCL completed in-service staff retraining certifications on administering clients’ medications.
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Based on interviews and record review the licensee did not comply with the section cited above in not assisting client with self- administering of medication, which poses an immediate health and safety risk to persons in care.
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Type B
02/10/2026
Section Cited
CCR
80061(a)(1)
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80061(a) Each licensee or applicant shall furnish to the licensing agency reports as required by the Department, including, but not limited to, those specified in this section. (1) Events reported shall include the following:

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By POC date, licensee agreed to read Title 22 Regulation 80061. Implement a plan regarding reporting requirements and send plan to CCL.
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This requirement was not met as evidenced by: Based on interviews and record review the Licensee did not comply with the section cited above in not reporting incident to CCL which poses an immediate health and safety risk to persons in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Tonica Syess-Gibson
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3